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26th Jul 2021

Advice on AstraZeneca varies across EU, amid blood clot fears

  • Despite the calls for coordination, member states began recommending different age limits for the AstraZeneca vaccine (Photo: Cheshire East Council)

The European Commission has said national experts should work together with the European Medicines Agency (EMA) to develop a "coherent approach" across the EU for the AstraZeneca vaccine.

The call comes as a jumble of measures emerged from EU governments, in response to concerns over rare blood clots.

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"Vaccination is a national competence, and member states may decide to follow a stricter approach when it comes to vaccines. [But] vaccination decisions in one member state can affect, of course, those in other member states," a commission spokesperson said on Thursday (8 April).

EU health ministers held an extraordinary virtual meeting on Wednesday, hours after the EU drug regulator found a possible link between AstraZeneca's coronavirus vaccine and rare cases of unusual blood clots with low blood platelets.

However, they failed to adopt a common guidance for its use given the "different interpretations" of the conclusions of the EMA's report.

EU commissioner for health Stella Kyriakides called, on Wednesday, for a coordinated European approach to ensure that "on the basis of the same set of evidence, similar decisions are taken in different member states".

"It is essential that we follow a coordinated European approach ... which does not confuse citizens, and that does not fuel vaccine hesitancy," she told ministers at the meeting, Reuters reported.

Despite the calls for coordination, member states began recommending different age limits for the use of the AstraZeneca vaccine.

"This is a technical decision ... not a political decision," warned Portuguese health minister Marta Temido, whose country currently holds the EU Council presidency.

Different age limits

The Netherlands, Germany, Italy, and Spain have all limited the use of the AstraZeneca vaccine to people aged over 60.

France and Belgium said the jab should only be given to those aged 55 and over.

And in Finland and Sweden, only people aged 65 and over will receive the jab.

Other countries in the bloc have not set age limits.

But British authorities have recommended that adults aged under 30 should be offered an alternative vaccine to the AstraZeneca jab.

Meanwhile, Germany has also recommended that those under 60 who have had a first AstraZeneca shot should receive a different vaccine for their second dose.

But the EU regulator said on Wednesday that there are no guidelines on the "mixing and matching" of different Covid-19 vaccines since there is no related data submitted or assessed so far by the EMA.

This new strategy is at odds with the initial approach in some member states, such as Germany, and France, which initially recommended AstraZeneca only for people under 65, or Italy and Spain, which recommended it only to those under 55, arguing that trial data for the elderly was insufficient.

Earlier in March, a dozen EU countries paused the vaccination with AstraZeneca over emerging reports of blood clotting - even though no causal link had been proven.

Lower trust?

Data from a survey published on Thursday revealed that citizens' trust in AstraZeneca is now lower than for other vaccines.

Among those who are not vaccinated, 65 percent showed some concern about the British-Swedish vaccine compared with about one-third for the other vaccines.

The EU agency pointed out on Wednesday that the benefits of the AstraZeneca jab still outweigh its risks, adding that it will continue monitoring the safety and effectiveness of this jab and other vaccines authorised in the EU.

The EMA's analysis is based on 164 cases of the rare brain blood clot, among 34 million doses administrated across the bloc.

By comparison, four women out of 10,000 would probably get a blood clot from taking the birth control pill.

Opinion

A neuroscientist writes on AstraZeneca fears

Irrespective of whether or not the decision to pause the AstraZeneca vaccine was political, it is clear that governments around the world are not solely basing their vaccination rollout on scientific evidence.

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Brexit, tabloid 'sulks', and AstraZeneca

A closer look at the events, however, shows that instead of a conspiracy the decision was old-fashioned bureaucratic caution. Isolated quotes by European officials were used to suit ideological agendas.

EU drugs agency plays down AstraZeneca 'blood clot' fears

The European Medicines Agency has said that the benefits of AstraZeneca's vaccine continue to outweigh the risks - suggesting countries can continue using the British-Swedish jab. Several member states have suspended its use over blood-clot concerns.

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The European Commission said on Thursday it has not yet decided whether to take legal action against AstraZeneca for failing to meet its contractual obligations - but repeated that all options are still on the table.

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